Department of Nuclear Medicine, CHRU Lapeyronie, 371 Av. du Doyen Gaston Giraud, 34295, Montpellier, France.
J Nucl Cardiol. 2011 Aug;18(4):642-9. doi: 10.1007/s12350-011-9407-7. Epub 2011 Jun 7.
Influence of CT-based attenuation correction (CT-AC) in assessment of left and right ventricular functions with count-based gated blood-pool SPECT (GBPS) was evaluated in a mixed population.
Thirty-two patients (81% male; mean age 56 ± 12) referred for various symptoms or heart diseases were prospectively included. Data from 32 GBPS acquisitions were reconstructed using an iterative algorithm with (IRAC) and without (IRNC) CT-AC and analyzed using previously described segmentation software based on the watershed algorithm. LV and RV EF and volumes were assessed with and without CT-AC and compared.
EF and volumes were correlated (P < .001 for all parameters with r = 0.97 for LV and RV EF; r = 0.96 for LV EDV; r = 0.98 for LV ESV; r = 0.96 for RV EDV and ESV). The mean values using IRAC and IRNC were different for all parameters with lower EF (respectively, 49% ± 19% vs 51 %± 18%; P = .002 for LV EF and 50% ± 14% vs 54%±15%; P < .001 for RV EF) and higher volumes (respectively, 142 ± 41 mL vs 133 ± 40 mL; P < .001 and 79 ± 45 mL vs 71 ± 42 mL; P < .001 for LV EDV and ESV; 91 ± 32 mL vs 86 ± 31 mL; P = .003 and 48 ± 28 mL vs 43 ± 26 mL; P < .001 for RV EDV and ESV). Limits of agreement were -11% to 6% and -11% to 4% for LV and RV EF. We found wider limits of agreement for LV volumes (-13 to 32 mL for EDV and -10 to 27 mL for ESV) than for RV volumes (-13 to 23 mL for EDV and -9 to 20 mL for ESV). Taking into account all volumes, we found a trend with a significant positive correlation between means and differences in volumes assessed with and without CT-AC.
Assessment of both left and right ventricular functions by count-based GBPS with CT-AC showed higher volumes and lower EF. Differences were slight, especially for the range of normal to subnormal ventricular volumes.
评估基于 CT 衰减校正（CT-AC）在计数门控血池 SPECT（GBPS）评估左、右心室功能中的影响。
前瞻性纳入 32 名（81%为男性；平均年龄 56±12 岁）因各种症状或心脏病就诊的患者。使用迭代算法（IRAC）和无 CT-AC（IRNC）对 32 次 GBPS 采集数据进行重建，并使用基于分水岭算法的先前描述的分割软件进行分析。评估左、右心室射血分数（EF）和容积，并比较有无 CT-AC 的结果。
EF 和容积呈正相关（所有参数的 P 值均<0.001，左、右心室 EF 的 r 值分别为 0.97；左心室舒张末期容积的 r 值为 0.96；左心室收缩末期容积的 r 值为 0.98；右心室舒张末期容积和收缩末期容积的 r 值分别为 0.96）。IRAC 和 IRNC 的均值在所有参数上均存在差异，EF 较低（分别为 49%±19%比 51%±18%；P=0.002 用于左心室 EF 和 50%±14%比 54%±15%；P<0.001 用于右心室 EF），容积较大（分别为 142±41mL 比 133±40mL；P<0.001 和 79±45mL 比 71±42mL；P<0.001 用于左心室舒张末期容积和收缩末期容积；91±32mL 比 86±31mL；P=0.003 和 48±28mL 比 43±26mL；P<0.001 用于右心室舒张末期容积和收缩末期容积）。左、右心室 EF 的一致性界限为-11%至 6%和-11%至 4%。我们发现左心室容积的一致性界限较宽（EDV 为-13 至 32mL，ESV 为-10 至 27mL），而右心室容积的一致性界限较窄（EDV 为-13 至 23mL，ESV 为-9 至 20mL）。考虑到所有容积，我们发现存在一个趋势，提示在有无 CT-AC 的情况下，容积评估的均值和差异之间存在显著正相关。
基于 CT-AC 的计数门控血池 SPECT 评估左、右心室功能显示出较高的容积和较低的 EF。差异较小，尤其是在正常至轻度低于正常心室容积范围内。
